약년자와 고령자에서 허혈성 뇌졸중의 위험요인 비교

Abstract

Background : Because the number of elderly is fast growing, the incidence of stroke in them is also increasing. Risk factors of ischemic stroke in young adults are relatively well known, but those in very elderly are little known, at present. The author evaluated the differences of risk factors and clinical characteristics of ischemic stroke between young adults and very elderly. Methods : The authors retrospectively studied patients who were consecutively admitted in Chosun University Hospital with cerebral infarction from January 1997 to December 2000. Among them, young adults whose age under forty five and very elderly whose age over eighty were selected in this study. The authors evaluated and compared gender, the extent, distribution and subtype of ischemic stroke, risk factors including hypertension, diabetes mellitus(DM), previous history of stroke, heart disease and smoking between two groups. Results : Five hundred and ninety five patients were admitted due to ischemic stroke during the study period. Twenty five(4.2%) and 37(6.2%) patients were included in young adults and very elderly group, respectively. Differences were significant between two groups in the history of DM, and mean fasting blood glucose level at admission. Six(24.0%) young adults had a history of DM, while only 2(5.4%) very elderly had it(p<0.05). Mean fasting blood glucose level was significantly higher(154.5¡¾33.8mg/dl) in young adults than that(116.8¡¾36.1mg/dl) in very elderly(p<0.05). In terms of stroke subtypes, young adults tended to have small vessel occlusion(56.0%), while very elderly tended to have large artery atherosclerosis(45.9%) (p=0.086). Very elderly tended to have a history of heart disease(27.0%) more often than young adults(8.0%) (p=0.065). There were no significant differences in gender, extent and distribution of stroke, history of hypertension, atrial fibrillation, and previous stroke, smoking, systolic and iastolic blood pressure level, laboratory findings including complete blood count and lipid profiles. Conclusions : Although there is a large age gap between two groups, risk factors of ischemic stroke were not different. The main risk factors of ischemic stroke in young adults were the history of smoking, hypertension and DM, while those in very elderly included smoking, hypertension and heart disease such as atrial fibrillation. Korean Journal of Stroke 2002;4(1): 13~17